Health literacy, socioeconomic status and self-rated health in Japan

TLDR

Health literacy is a key determinant of health, with basic literacy linked to better outcomes, yet the role of communicative/critical literacy and its interaction with socioeconomic status remains underexplored. The study examined whether communicative/critical health literacy predicts self‑rated health in Japan after adjusting for socioeconomic factors. A cross‑sectional survey of 1,237 Japanese adults (62% response) assessed communicative/critical health literacy with three items and adjusted for age, gender, income, employment, and education. Higher communicative/critical health literacy, younger age, and employment were independently associated with better self‑rated health, and lower education correlated with poorer literacy, suggesting targeted HL promotion could reduce health disparities.

Abstract

Health literacy (HL) is a key determinant of health in a contemporary society characterized by abundant information. Previous studies have suggested that basic or functional HL is positively associated with health, whereas evidences on the association between health and communicative/critical HL are scarce. Furthermore, confounding by socioeconomic status on HL-health association has been poorly tested. Using cross-sectional data from a nationally representative community-based survey in Japan, we investigated whether communicative/critical HL is associated with self-rated health independent of socioeconomic status. A total of 1237 subjects participated in this study; the response rate was 62%. To measure communicative/critical HL, we used three questions assessing the respondents' ability to select, to communicate to others and to evaluate specific health-related information. Potential confounders included demographic factors, household income, employment status, and educational attainment. A multivariate model revealed that good self-reported health was significantly associated with younger age [odds ratio (OR), 0.99; 95% confidence interval (CI), 0.97–0.99], employment (OR, 2.89; 95% CI, 1.06–7.88) and higher communicative/critical HL scores (OR 2.75; 95%CI, 1.93–3.90). Respondents with lower education were likely to have poorer communicative/critical HL. These results imply that to close the health gap, policy interventions should focus on the promotion of HL among deprived sociodemographic groups.